Prior techniques to reduce the trauma and expense of cardiac surgery include closed chest procedures using specially configured catheter-based apparatus to achieve cardiopulmonary bypass (CPB) combined with less invasive port-access type incision and special techniques and apparatus to eliminate CPB by employing a minimally invasive surgical technique and performance at the surgical procedure on the beating heart. These existing closed chest procedures eliminate the trauma associated with an open chest incision but still have the drawbacks associated with CPB. The existing beating heart procedures avoid CPB but still typically require a transthoracic incision, i.e., an incision that penetrates the rib cage in some fashion. Thus, while these approaches provide a less invasive procedure compared to the traditional medial sternotomy or thoracotomy, any procedure that traverses the ribs or sternum may cause complications and may slow the post-operative recovery of the patient.